Dermatopathological characteristics of dermatofibromas from dermatoscopic clues

Abstract

Background Several types of dermatofibroma (DF) have been identified dermatopathologically and with dermatoscopic correlation, the dermatopathology has been predictable in limited studies so far. We identify DFs with specific dermatoscopic structures and determine the respective dermatopathological correlates. Methods Dermatoscopic and dermatopathologic correlation of 403 DFs were assessed. A pattern analysis algorithm was used for the dermatoscopic evaluation, each lesion being evaluated according to 10 dermatoscopic patterns with further subdivision of the atypical subtype according and their dermatoscopic similarities to other defined skin lesions. Results Dermatoscopic pattern analysis showed typical patterns in 83.4% of DFs with atypical patterns in 16.6%. We classified the atypical DFs according to their dermatoscopic similarity to certain lesions: Melanoma‐like 2.7%, basal cell carcinoma‐like 0.7%, keratoacanthoma‐like 0.5%, seborrheic keratosis‐like 2.7%; nevus‐like 1.5%; nevus sebaceous‐like 0.9%; xanthogranuloma‐like 0.5%; pyogenic granuloma‐like 0.5%; and spitzoid 6.5%. Dermatopathologically 12 subtypes of DFs were identified. It was found that the most common pattern found in fibrocollagenous DFs was the typical pattern with peripheral reticular lines and central white structureless area (32.9%) whereas non‐fibrocollagenous types were more likely to have atypical patterns (65.1%). Conclusions Our study resulted in new conclusions while supporting some previous findings. The fact that the pathogenesis of DF involves a reactive inflammatory process with fibrosis is likely to have diverse effects on dermatoscopic morphology. If atypical dermatoscopic patterns are identified in suspected DF, excisional biopsy may be prudent.

Connective tissue nevus—Isolated collagenoma

“…Among them, IC is a rare type of acquired collagen CTN with an unknown etiology, which has been suggested to be related to a limited proliferation of type I collagen and a reduced amount of collagenase. 2 Nasrin Saki et al 3 et al 4 verified the histopathological features of typical dermatofibroma and atypical dermatofibroma by dermatoscopy, which provided a basis for the need of histopathology for clinical atypical dermatofibroma. In addition, reflective confocal microscopy is widely used in the diagnosis and treatment of skin tumors and inflammatory diseases.…”

“…Yeser Genc et al. 4 verified the histopathological features of typical dermatofibroma and atypical dermatofibroma by dermatoscopy, which provided a basis for the need of histopathology for clinical atypical dermatofibroma. In addition, reflective confocal microscopy is widely used in the diagnosis and treatment of skin tumors and inflammatory diseases.…”

Dermoscopic findings of hemosiderotic dermatofibroma: A comprehensive review

“…Very few DF presented vascular structures, the ones who did had dot vessels and comma like vessels; other findings were white superficial scale [6] . [11] 1981 Japan 1 NS No Yes Requena et al [7] 1990 Spain 1 Circumscribed angiokeratoma No Yes Blum et al [14] 2004 Germany 1 Melanoma Yes Yes Zaballos et al [1] 2006 Spain 4 NS Yes Yes Cardoso et al [15] 2007 Portugal 1 Melanoma Yes Yes Kilinc et al [8] 2007 Turkey 3 NS Yes* Yes Scalvenzi et al [19] 2007 Italy 1 NS Yes Yes Alves et al [9] 2014 Portugal 11 NS No Yes Roldán-Marin et al [16] 2014 Spain 2 Melanoma Yes Yes Laureano et al [12] 2015 Portugal 1 Melanoma Yes Yes Kelati et al [6] 2017 Morocco 4 NS Yes* Yes Villareal et al [10] 2017 Brazil 1 Melanoma Yes Yes Acar et al [17] 2018 Turkey 1 Melanoma Yes Yes Genc et al [20] 2020 Turkey 1 NS Yes* Yes Lagziel et al [18] 2020 USA 1 Melanoma No Yes *No information of each lesion. NS: Not specified Focal blue-red area on a white structureless background and pink-red area at periphery surrounded by brown pigment [17] M: male, F: female, NS: Not specified…”